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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />rdi <br />-L0021 <br />CITY ENGINEERS _ <br />EVERETT,WASHINGTON �/j PERMIT NO. 74 <br />The Undersigned R � '-) 1 `� 1 <br />Hereby applies for permission to CC 0 S T/L, ,� Z�� /a 51pN D & 1 IAIazA-u <br />At the following location i0 -2- 2. Rne.leEFt=L LL=T2. _. <br />(Work to be (lone) <br />�Qf <br />DRIVEWAY SECTION <br />--_ NO SCALE <br />2 <br />+I" LIP <br />DU PL- C--X <br />6�2 vy <br />Z` 4; <br />I i <br />N o ScAL.E <br />/�L z <br />—`�� c- )4 PAVt <br />RockG.r-I.L_LLR tA\S <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECKLIST <br />Water Valve <br />Drainage - <br />Curb & Gutter <br />Sidewalk <br />Q Al � &Ati 69,> Q /0 _L - 7 y <br />Inspector's Signature <br />-7-zs��<< <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10021 <br />1 Copy to Inspector <br />433r <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa. <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice fro" a City and to replace public property <br />image iL�' <br />t <br />Date 1,A1 14l 7- 3/-7Y <br />ee <br />REc tp 9� Dept. Approvals <br />.-7A <br />Approved by t <br />Date Approved <br />